Developing a Spatial-Skills-Focused Music Program for Older Adults With Changes in Cognition

Abstract Older adults with cognitive changes need stimulating programming to maximize their cognitive abilities. One area to maximize includes spatial skills, its decline can lead to disorientation and wandering. Music has potential to maximize spatial skills: reading music’s notation is associated with enhanced spatial skills in children and professional musicians. It’s critical to understand the potential impact of a spatially focused music program for older adults with changing cognition; if successful, future music programs could support people staying orientated in their environments and living independently longer. We developed and assessed a six-week marimba program focused on reading music with 15 older adults ages 65-89 with changes in cognition. We compared their scores on the Orientation Test from the Test of Visual Perceptual Skills pre- and post-intervention and assessed if participants self-selected to read music notation. Participants scored an average Modified Mini Mental State Examination (3MSE) score of 81.3 (SD = 11.0). On average, participants’ scores on the Orientation Test moved from 13.4 (SD =1.9) to 14.1 (SD= 2.7), providing a cohen’s d effect size of 0.3. Over the six weeks, 11 out of the 15 participants selected to read music for at least one class, indicating a statistically significant change using the Wilcoxon signed-rank test (Z = -3.16, p < 0.01), suggesting that older adults with cognitive changes may be able to learn to read music. This is important, as a spatially focused music program may maximize spatial skills that older adults need to successfully navigate their world safely and independently.

Download Full-text

Changing our thinking about changing their thinking in older adulthood

International Psychogeriatrics ◽

10.1017/s1041610217001302 ◽

2017 ◽

Vol 29 (9) ◽

pp. 1405-1407

Author(s):

Viviana M. Wuthrich

Keyword(s):

Older Adults ◽

Individual Differences ◽

Cognitive Flexibility ◽

Cognitive Deficits ◽

Processing Speed ◽

Cognitive Abilities ◽

Anxiety And Depression ◽

Cognitive Changes ◽

Older Adulthood ◽

New Learning

It is well-established that as people age, deterioration in cognitive abilities including processing speed, memory, and cognitive flexibility occurs, although vast individual differences occur in the rate and consequences of this decline (Christensen, 2001). Anxiety and depression in late life are also associated with specific cognitive deficits in memory and executive functioning that may impact on new learning (Yochim et al., 2013). Therefore, it is possible that cognitive changes make it more difficult for older adults to learn how to change their thinking particularly in the context of psychological therapy.

Download Full-text

THE RELATIONSHIP BETWEEN COGNITION, FUNCTIONAL ABILITIES, AND THE LATENT DEMENTIA PHENOTYPE AMONG CENTENARIANS

Innovation in Aging ◽

10.1093/geroni/igz038.3498 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S965-S965

Author(s):

Jonathan Sober ◽

John L Woodard ◽

L Stephen Miller ◽

Adam Davey ◽

Peter Martin ◽

...

Keyword(s):

Older Adults ◽

Cognitive Abilities ◽

Latent Variable ◽

Structural Equation ◽

Cognitive Status ◽

Community Dwelling ◽

Self Report ◽

Functional Abilities ◽

Cognitive Changes ◽

Dementia Severity

Abstract Adequate assessment of cognitive abilities and functional capacity is essential for a diagnosis of dementia. However, cognition is only moderately related to functional status, and this relationship is poorly understood among centenarians, a group of older adults with high risk for dementia. A bifactor structural equation model can be used to delineate the variance attributed to dementia-specific related cognitive changes (i.e., the latent variable delta) and the variance due to general intelligence (i.e., g’). This study aimed to determine the validity of delta as a marker of cognitive decline among centenarians. It was hypothesized that delta was correlated with cognitive status, functional abilities and, dementia severity. Overall, 244 community dwelling centenarians (Mage = 100.58, 84.8% female) were recruited through the Georgia Centenarian Study, a population-based study of octogenarians and centenarians from northern Georgia. Older adults were administered measures of cognition and a self-report measure of functional abilities. Latent variable scores (i.e., g’ and delta) were modeled and correlated with standard global cognitive screening measures (i.e., MMSE) and measures of dementia severity. Results indicate that delta was significantly correlated with functional ability and cognitive abilities. Consistent with our hypotheses, delta was also significantly related to dementia severity. Overall, estimates of the latent dementia phenotype, delta, were significantly related to cognitive and functional abilities among centenarians, providing validation of delta as a useful index of dementia severity.

Download Full-text

C-01 An Evaluative Study of a Cognitive Training Program on Cognitive Outcomes in Older Adults with Moderate to Severe Cognitive Impairment

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acz034.163 ◽

2019 ◽

Vol 34 (6) ◽

pp. 1028-1028

Author(s):

A Dye ◽

J Gehling ◽

J Buchanan

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Training Program ◽

Cognitive Training ◽

Effect Sizes ◽

Medium Effect ◽

Post Intervention ◽

Cognitive Changes ◽

Severe Cognitive Impairment ◽

Limited Effectiveness

Abstract Objective Because medical interventions for persons with dementia have limited effectiveness, there is a need to evaluate non-pharmacological interventions designed to support individuals with cognitive impairment. Cognitive training is a non-pharmacological approach aimed at improving or maintaining cognitive functioning through practice. The current study evaluated the effects of a cognitive training program in older adults with moderate to severe cognitive impairment. Method Data were collected from seven females and one male with a mean age of 83.1 who met criteria for moderate to severe cognitive impairment as defined by a Modified Mini-Mental Status Exam score between 49-77 (M = 54.5). Participants were recruited from two organizations that provide housing and supportive services for older adults with cognitive impairments. Cognitive changes were measured using the Repeatable Battery for the Assessment of Neuropsychological Status-Update. Results Effect sizes (Cohen’s d) were calculated to measure the magnitude of change from pre- to post-intervention. Results indicated no change in the domains of immediate memory (d = -0.08) and attention (d = -0.17). A medium effect size was found in delayed memory (d = 0.68), while large effect sizes were found in language (d = 1.70), visuospatial/constructional (d = 0.89), and the total scale index (d = 1.40). Conclusion The results provide tentative support for the effectiveness of cognitive training in maintaining or improving some cognitive abilities in older adults with moderate to severe cognitive impairment. Further research with larger samples sizes and control groups are necessary to verify these preliminary findings and to determine if benefits generalize to everyday life.

Download Full-text

Online Personalised Training in Memory Strategies for Everyday (OPTIMiSE) Program for Older Adults with Cognitive Concerns: Pilot Study Protocol

Journal of Alzheimer s Disease Reports ◽

10.3233/adr-200251 ◽

2021 ◽

Vol 5 (1) ◽

pp. 143-152

Author(s):

Kerryn E. Pike ◽

Carl I. Moller ◽

Christina Bryant ◽

Maree Farrow ◽

Duy P. Dao ◽

...

Keyword(s):

Older Adults ◽

Pilot Study ◽

Outcome Measures ◽

Memory Performance ◽

Secondary Outcome ◽

Access Barriers ◽

Post Intervention ◽

Cognitive Changes ◽

Memory Strategies ◽

Increased Risk

Memory interventions for older adults with cognitive concerns result in improved memory performance and maintenance of cognitive health. These programs are typically delivered face-to-face, which is resource intensive and creates access barriers, particularly for those with reduced mobility, limited transportation, and living in rural or remote areas. The COVID-19 pandemic has created an additional access barrier, given the increased risk this disease poses to older adults. Internet-based interventions seek to overcome these barriers. This paper describes the protocol of a pilot study that aims to evaluate the feasibility, acceptability, and efficacy of one such internet-based intervention: the Online Personalised Training in Memory Strategies for Everyday (OPTIMiSE) program. OPTIMiSE focuses on improving knowledge regarding memory and providing training in effective memory strategies for everyday life. The pilot study described in this protocol will be a single-arm pre-post study of 8 weeks duration, with a single maintenance session 3 months post-intervention. Participants will be Australian adults aged ≥60 years reporting cognitive changes compared with 10 years ago. Primary outcome measures will address feasibility, acceptability, and efficacy. Secondary outcome measures assessing sense of community and self-efficacy will be administered at the 8-week and 3-month timepoints. Data collection will conclude mid-2021, and results will be presented in a subsequent publication. Translation of memory interventions to internet-based delivery has the potential to remove many access barriers for older adults; however, the acceptability and feasibility of this modality needs investigation. OPTIMiSE is the initial step in what could be an important program enabling access to an evidence-based memory intervention for older adults worldwide. Trial registration: Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN12620000979954

Download Full-text

The Effects of Cognitive Training Program for Older Adults: A Brief Preliminary Report

International Journal of Aging Research ◽

10.28933/ijoar-2021-07-0706 ◽

2021 ◽

pp. 86

Author(s):

Keyword(s):

Older Adults ◽

Cognitive Decline ◽

Training Program ◽

Cognitive Training ◽

Verbal Memory ◽

Cognitive Abilities ◽

Cognitive Outcome ◽

Cognitive Changes ◽

Cognitive Domains ◽

Visual Spatial

As one ages, some degree of cognitive decline is expected. Despite this, declines in cognitive abilities and the possibility of dementia is a common concern among older adults. In response to these concerns, a variety of cognitive training programs has been developed that aim to improve or maintain cognitive functioning. Prior literature has shown mixed or limited findings on cognitive changes after implementation of cognitive training. This study evaluated the effectiveness of a cognitive training program designed for older adults with no to minimal cognitive decline. The current study included 17 participants who engaged in two one-hour cognitive training sessions each week for 12 weeks. Each session required participants to complete activities that targeted the following cognitive domains: attention, visual and verbal memory, visual spatial skills, processing speed and executive functioning, and language. These cognitive domains, along with depression and memory self-efficacy, were assessed prior to and immediately after completion of the program. Small to large effect sizes on the majority of cognitive outcome measures were observed following participation in the program. Small reductions in depressive symptoms were also found. These findings provide preliminary support for the use of a comprehensive cognitive training program for cognitively-intact older adults.

Download Full-text

Does Practicing with a Virtual Reality Driving Simulator Improve Spatial Cognition in Older Adults? A Pilot Study

Neuroscience Insights ◽

10.1177/2633105520967930 ◽

2020 ◽

Vol 15 ◽

pp. 263310552096793

Author(s):

Sogol Masoumzadeh ◽

Zahra Moussavi

Keyword(s):

Older Adults ◽

Virtual Reality ◽

Spatial Cognition ◽

Driving Simulator ◽

Depression Scale ◽

Serious Game ◽

Spatial Skills ◽

Post Intervention ◽

Before And After ◽

Water Test

Memory, cognition, executive functioning, and spatial cognition loss are prevalent in the normal aging process, but these impairments are observed more extensively in individuals with dementia, specifically Alzheimer’s disease. To improve the impaired functions, serious games targeting the lost functions are commonly developed and used in training programs. In this study, we designed a virtual reality driving simulator (VRDS) as a serious game with different difficulty levels for improving the spatial cognition; we evaluated it on 11 participants with different levels of dementia for two weeks, every day except weekends (10 sessions of practice in total) and 30 min/day. We assessed the participants’ spatial cognition before and after the intervention by an independent assessment (the VR replica of Morris Water test) and also by their performance playing the VRDS during the intervention. We also assessed the participants’ mood by a standard depression scale as well as their plausible experience of simulation sickness. The results showed significant improvement in Morris water test. The participants’ normalized correct trajectory (to find the target) was improved significantly by 44.4% at post-intervention with respect to baseline. Furthermore, on average, the participants progressed to higher (more challenging) levels of the game, and their spatial learning score increased throughout the sessions. Their mood also showed improvement with respect to baseline. Overall, the results hold promise for the designed VRDS as a mood-lifting and enhancing spatial skills serious game for older adults if it is played regularly. Trial Registry name: Investigating the Effect of Training with a Virtual Reality Driving Simulator URL: https://clinicaltrials.gov/ct2/show/NCT04074655 Clinical Trials.gov ID: NCT04074655

Download Full-text

Virtual reality video game improves high-fidelity memory in older adults

Scientific Reports ◽

10.1038/s41598-021-82109-3 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Peter E. Wais ◽

Melissa Arioli ◽

Roger Anguera-Singla ◽

Adam Gazzaley

Keyword(s):

Older Adults ◽

Virtual Reality ◽

Video Game ◽

Cognitive Abilities ◽

Environmental Enrichment ◽

Cognitive Intervention ◽

Therapeutic Interventions ◽

Placebo Control ◽

Long Term Memory ◽

High Fidelity

AbstractTherapeutic interventions have not yet been shown to demonstrate restorative effects for declining long-term memory (LTM) that affects many healthy older adults. We developed a virtual reality (VR) spatial wayfinding game (Labyrinth-VR) as a cognitive intervention with the hypothesis that it could improve detailed, high-fidelity LTM capability. Spatial navigation tasks have been used as a means to achieve environmental enrichment via exposure to and learning about novel and complex information. Engagement has been shown to enhance learning and has been linked to the vitality of the LTM system in the brain. In the current study, 48 older adults (mean age 68.7 ± 6.4 years) with average cognitive abilities for their age were randomly assigned to 12 h of computer game play over four weeks in either the Labyrinth-VR or placebo control game arms. Promptly before and after each participant’s treatment regimen, high-fidelity LTM outcome measures were tested to assess mnemonic discrimination and other memory measures. The results showed a post-treatment gain in high-fidelity LTM capability for the Labyrinth-VR arm, relative to placebo, which reached the levels attained by younger adults in another experiment. This novel finding demonstrates generalization of benefits from the VR wayfinding game to important, and untrained, LTM capabilities. These cognitive results are discussed in the light of relevant research for hippocampal-dependent memory functions.

Download Full-text

The impact of a music education program on meta-musical awareness, logical-mathematical, and notational skills in preschoolers

International Journal of Music Education ◽

10.1177/02557614211027247 ◽

2021 ◽

pp. 025576142110272

Author(s):

Oriana Incognito ◽

Laura Scaccioni ◽

Giuliana Pinto

Keyword(s):

Music Education ◽

Education Program ◽

Cognitive Abilities ◽

Musical Training ◽

Control Group ◽

Transfer Of Knowledge ◽

General Domain ◽

Music Program ◽

Before And After ◽

The Impact

A number of studies suggest a link between musical training and both specific and general cognitive abilities, but despite some positive results, there is disagreement about which abilities are improved. This study aims to investigate the effects of a music education program both on a domain-specific competence (meta-musical awareness), and on general domain competences, that is, cognitive abilities (logical-mathematical) and symbolic-linguistic abilities (notational). Twenty 4- to 6-year-old children participated in the research, divided into two groups (experimental and control) and the measures were administered at two different times, before and after a 6-month music program (for the experimental group) and after a sports training program (for the control group). Children performed meta-musical awareness tasks, logical-mathematical tasks, and emergent-alphabetization tasks. Non-parametric statistics show that a music program significantly improves the development of notational skills and meta-musical awareness while not the development of logical-mathematical skills. These results show that a musical program increases children’s meta-musical awareness, and their ability to acquire the notational ability involved in the invented writing of words and numbers. On the contrary, it does not affect the development of logical skills. The results are discussed in terms of transfer of knowledge processes and of specific versus general domain effects of a musical program.

Download Full-text

Complex multimorbidity and mortality in Japan: a prospective propensity-matched cohort study

BMJ Open ◽

10.1136/bmjopen-2020-046749 ◽

2021 ◽

Vol 11 (8) ◽

pp. e046749

Author(s):

Daisuke Kato ◽

Ichiro Kawachi ◽

Junko Saito ◽

Naoki Kondo

Keyword(s):

Older Adults ◽

Cohort Study ◽

Health Behaviours ◽

Evaluation Study ◽

Rank Test ◽

Baseline Survey ◽

Similar Degree ◽

Matched Cohort ◽

Log Rank Test ◽

Prediction Of Mortality

ObjectivesThere are limitations to defining multimorbidity (MM) based on a simple count of diseases. To address these limitations, the concept of complex MM (CMM) focuses on how many body systems are affected in a single patient, rather than counting comorbid conditions. This study compared the prediction of mortality among older Japanese adults between CMM and conventional MM.DesignA population-based prospective cohort study.SettingThe Japan Gerontological Evaluation Study, a nationwide longitudinal cohort study, which ran from 2010 to 2016.ParticipantsFunctionally independent individuals who were older than 65 and had complete illness data at the time of baseline survey were eligible.Outcomes measureCMM was defined as the coexistence of 3 or more body system disorders at baseline. We calculated the propensity for each individual to develop CMM based on a wide array of characteristics, including socioeconomic status and health behaviours. Individuals with and without CMM were then matched on their propensity scores before we estimated overall survival using a log-rank test.ResultsOur 6-year follow-up included 38 889 older adults: 20 233 (52.0%) and 7565 (19.5%) adults with MM and CMM, respectively. In the MM-matched cohort (n=15 666 pairs), the presence of MM was significantly associated with increased mortality (HR 1.07; 95% CI 1.01 to 1.14; p=0.02 by the log-rank test). A similar mortality association was found in the CMM-matched cohort (n=7524 pairs, HR, 1.07; 95% CI 0.99 to 1.16; p=0.08 by the log-rank test).ConclusionThis is the first study to report the association between CMM and mortality among older adults in Japan. MM and CMM predict mortality in older adults to a similar degree. This finding needs to be replicated with more precision in larger samples.

Download Full-text

Promoting Problem Solving About Health Management: A Mixed-Methods Pilot Evaluation of a Digital Health Intervention for Older Adults With Pre-Frailty and Frailty

Gerontology and Geriatric Medicine ◽

10.1177/2333721420985684 ◽

2021 ◽

Vol 7 ◽

pp. 233372142098568

Author(s):

Annie T. Chen ◽

Frances Chu ◽

Andrew K. Teng ◽

Soojeong Han ◽

Shih-Yin Lin ◽

...

Keyword(s):

Older Adults ◽

Mixed Methods ◽

Health Literacy ◽

Problem Solving ◽

Self Efficacy ◽

Health Management ◽

Digital Health ◽

Post Intervention ◽

Problem Solving Skills ◽

Health Related

Background: There is a need for interventions to promote health management of older adults with pre-frailty and frailty. Technology poses promising solutions, but questions exist about effective delivery. Objectives: We present the results of a mixed-methods pilot evaluation of Virtual Online Communities for Older Adults (VOCALE), an 8-week intervention conducted in the northwestern United States, in which participants shared health-related experiences and applied problem solving skills in a Facebook group. Methods: We performed a mixed-methods process evaluation, integrating quantitative and qualitative data, to characterize the intervention and its effects. We focus on four areas: health-related measures (health literacy and self-efficacy), participation, problem solving skills enacted, and subjective feedback. Results: Eight older adults with pre-frailty and frailty (age = 82.7 ± 6.6 years) completed the study. There was an upward trend in health literacy and health self-efficacy post-intervention. Participants posted at least two times per week. Content analysis of 210 posts showed participants were able to apply the problem solving skills taught, and exit interviews showed participants’ increased awareness of the need to manage health, and enjoyment in learning about others. Conclusion: This mixed-methods evaluation provides insight into feasibility and design considerations for online interventions to promote health management among vulnerable older adults.

Download Full-text